India’s medicare: disallow cow slaughter, but not human slaughter

Most sociologists insist that the two crucial indicators which point to a government’s commitment to improving the lot of its people are education and health. The first allows people to grow. The other ensures that growth is not blighted with disease.

There is reason to believe that the government has not really cared about who dies in India (http://www.freepressjournal.in/does-anybody-care-for-the-dead/). Countless people die on roads, in riots, and even before they reach hospitals. But, for almost 70 years, successive governments have not really bothered about knowing who dies and why. It was only recently that the government acknowledged that only 14% of its deaths were actually being accounted for and duly registered. Only 20% of these (or less than 3% of all deaths) were medically certified.

Now comes news that the government has allowed the entire medical profession to dupe its people into believing that they were in safe hands. A recent publication — based on findings of the WHO (the United Nations’ World Health Organisation) — shows that half the doctors in India are without any medical qualification. The WHO has not yet officially confirmed these figures, say officials of the Medical Council of India (MCI). But even so, the findings are alarming.

The book, ‘The Health Workforce in India’ (2016) authored by by Anand S and Fan V of the WHO, point out that only 18.8% of rural medical practitioners who claim that they are doctors are actually medically qualified to practice modern medicine. So what is the government’s much vaunted medical insurance all about? Insurance claims to be certified by quacks?

If that is not bad enough, 31% of the doctors who claim to be trained in allopathic medicine were found to have been educated only till secondary levels; while 57% of the doctors did not possess any medical qualifications.

The study, conducted by WHO, was based on data collected at district level according to the country’s Census-2011. Clearly, the healthcare system is nowhere as robust as is made out to be.

Yet, in spite of this fudge, the number of doctors in India remains quite low. At the national level, doctors (allopathic, homeopathic and Unani) comprised just 79.7 for a population of 100,000 (a lakh). That means that India has barely 0.8 doctors for a population of 1,000. It is lower (0.6) for nurses and midwives. The comparative figures for China in 2005 were 1.3 for doctors and 0.96 for nurses.

But even these figures for India could be highly inflated. According to published WHO data (see table alongside), doctors accounted for just 0.7 per 1,000 people in 2012. This is far below the need for 1 per 1,000 recommended by WHO. And if one discounts this WHO number for the quacks who practice medicine, the ratio could tumble to under 0.35. China scores over India (with 1.49 doctors per 1,000 people), though India appears to have more nurses and dentists than China – see table).

According to data compiled by Anand S and Fan V,

Of all doctors, 2% were allopathic and 22.8% were ayurvedic, homeopathic or Unani.These figures are at variance with those published in Indian media (see chart).

Almost 31.4% of those who called themselves allopathic doctors in 2001 were educated only till the secondary school level; and as many as 3% did not have medical qualifications.

Consequently, rural areas suffer most. Whereas 4% of allopathic doctors in urban areas were medically qualified, only 18.8% of those in rural areas had such a qualification.

The skewed nature of medicare in India also becomes quite obvious. For instance:

The state of Keralahas 4% of the country’s medically qualified nurses but has only 3.1% of the country’s population.

West Bengalhas 6% of all homoeopathic doctors.

More details will emerge once the WHO updates its figures on its website. But one thing is clear. India has messed up its medicare – big time.

In fact, India loves milking the medical industry.

Look at private medical colleges. They are cumulatively allowed to take in few students, so that the artificial scarcity of seats compels people to pay donations of anywhere between Rs.50 lakh and Rs.1.5 crore.

Then look at how ayurveda and homeopathy colleges are allowed to make more money. In several states homeopathy and ayurveda graduates allowed to practice allopathy as well (this is being challenged in the courts). Effectively, India becomes a country where there is more frenzy in preventing cow slaughter than the slaughter of humans at the hands of quacks.

Thus money is made by the unscrupulous – either by way of donations, or by displaying bogus qualifications. India has excelled more in the art of promoting the illegitimate rather than having systems which would ease the lives of its millions.

Journalist. Educationist. Researcher
Current activities include
Journalism: was a full time journalist till 1998 when I was editor with one of the largest media groups in India.
Education: Was a full time teacher and education administrator till 1982 (have taught and both undergraduate postgraduate levels)
Research: undertake specific research projects in select areas.

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Countries improve when they have the right policies. Implementation comes thereafter. But when the policies are wrong, there could be trouble ahead. These articles are about policies, and what must be done to set them right.

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